Provider Demographics
NPI:1407014376
Name:HUMAN RESOURCES CENTER OF EDGAR AND CLARK COUNTIES
Entity Type:Organization
Organization Name:HUMAN RESOURCES CENTER OF EDGAR AND CLARK COUNTIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BURNS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:217-465-4118
Mailing Address - Street 1:PO BOX 1118
Mailing Address - Street 2:118 EAST COURT STREET
Mailing Address - City:PARIS
Mailing Address - State:IL
Mailing Address - Zip Code:61944-5118
Mailing Address - Country:US
Mailing Address - Phone:217-465-4118
Mailing Address - Fax:217-463-1899
Practice Address - Street 1:406 N 2ND ST
Practice Address - Street 2:
Practice Address - City:MARSHALL
Practice Address - State:IL
Practice Address - Zip Code:62441-1075
Practice Address - Country:US
Practice Address - Phone:217-465-4118
Practice Address - Fax:217-463-1899
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-28
Last Update Date:2021-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILA02360001AOtherIL DEPARTMENT OF HUMAN SERVICES
ILA02360001AOtherIL DEPARTMENT OF HUMAN SERVICES